Headache is a chronic disease that occurs with varying frequency and results
in varying levels of disability. To date, the majority of research and clinical focus
has been on the role of biological factors in headache and headache-related disability.
However, reliance on a purely biomedical model of headache does not account for all aspects
of headache and associated disability. Using a biopsychosocial framework, the current
manuscript expands the view of what factors influence headache by considering the role
psychological (i.e. cognitive and affective) factors have in the development, course,
and consequence of headache. The manuscript initially reviews evidence showing that
neural circuits responsible for cognitive-affective phenomena are highly
interconnected with the circuitry responsible for headache pain. The manuscript
then reviews the influence cognitions (locus of control and self-efficacy) and
negative affect (depression, anxiety, and anger) have on the development of
headache attacks, perception of headache pain, adherence to prescribed treatment,
headache treatment outcome, and headache-related disability. The manuscript
concludes with a discussion of the clinical implications of considering psychological
factors when treating headache.